Medical Image Segmentation

In pathology, the spatial distribution and proportions of tissue types are key indicators of disease progression, and are more readily available than fine-grained annotations. However, these assessments are rarely mapped to pixel-wise segmentation. The task is fundamentally underdetermined, as many spatially distinct segmentations can satisfy the same global proportions in the absence of pixel-wise constraints. To address this, we introduce Variational Segmentation from Label Proportions (VSLP), a two-stage framework that infers dense segmentations from global label proportions, without any pixel-level annotations. This framework first leverages a pre-trained transformer model with test-time augmentation to produce a pixel-wise confidence estimate. In the second stage, these estimates are fused by solving a variational optimization problem that incorporates a Wasserstein data fidelity term alongside a learned regularizer. Unlike end-to-end networks, our variational method can visualize the fidelity-regularization energy, resulting in more interpretable segmentation. We validate our approach on two public datasets, achieving superior performance over existing weakly supervised and unsupervised methods. For one of these datasets, proportions have been estimated by an experienced pathologist to provide a realistic benchmark to the community. Furthermore, the method scales to an in-house dataset with noisy pathologist labels, severely outperforming state-of-the-art methods, thereby demonstrating practical applicability. The code and data will be made publicly available upon acceptance at https://github.com/xiaoliangpi/VSLP.

The technological maturity of in situ inspection and monitoring methods in additive manufacturing is steadily increasing, enabling more efficient and practical qualification procedures. In this context, image segmentation of powder bed images in Laser Powder Bed Fusion (L-PBF) has been investigated by various authors, leveraging both edge detection and machine learning approaches to identify deviations from nominal geometry. Despite these developments, several challenges remain, including the sensitivity of segmentation performance to industrial illumination conditions and layer-to-layer variability in pixel intensity patterns. The study addresses these limitations by proposing a graph-augmented segmentation approach. The underlying principle consists of preserving the geometrical information at a global level rather than at pixel-wise level, modeling dependencies and relational information among spatial regions with a Graph Neural Network bottleneck embedded into a U-Net architecture. This allows enhancing the consistency and accuracy of the geometry reconstruction in the presence of spatial and layer-wise photometric variability systematically faced in real data. The method is evaluated against benchmark techniques for the in situ reconstruction of lattice structures produced by L-PBF, demonstrating its potential as a scalable solution for robust in situ inspection and geometric verification in industrial environments.

Semi-supervised learning (SSL) has become a promising solution to alleviate the annotation burden of deep learning-based medical image segmentation models. While recent advances in foundation model-driven SSL have pushed the boundary to extremely limited annotation scenarios, they fail to maintain robust competitive performance in complex imaging modalities. In this paper, we propose SemiSAM-O1, an annotation-efficient framework using only one annotated template image for segmentation. SemiSAM-O1 extends the specialist-generalist collaborative learning framework to the extreme one-label setting by fully exploiting the foundation model's feature representation capability beyond its prompting interface. SemiSAM-O1 operates in two stages. In the first stage, the foundation model's encoder extracts dense features from all volumes, and class prototypes derived from the single annotated template are propagated to the unlabeled pool via feature similarity to produce coarse initial pseudo-labels. In the second stage, an iterative training-and-refinement loop progressively improves both the segmentation model and the pseudo-labels over multiple rounds, where each round trains the model from scratch on current pseudo-labels and generates updated predictions with voxel-wise uncertainty estimates. An uncertainty-guided refinement step further leverages the foundation model's global feature space to correct high-uncertainty regions by aggregating labels from their most similar confident neighbors, establishing a virtuous cycle of mutual improvement. Extensive experiments on a wide range of segmentation tasks across different modalities and anatomical targets demonstrate that SemiSAM-O1 significantly narrows the performance gap between one-label semi-supervised learning and full supervision, while significantly reducing the computational overhead of online foundation model inference.

Breast cancer is a leading cause of cancer-related mortality among women worldwide, with mammography as the primary screening tool. While deep learning models have shown strong performance in lesion segmentation, most rely on computationally intensive architectures that limit their use in resource-constrained environments. This study evaluates the performance and efficiency of lightweight models for mammographic lesion segmentation. Architectures including MobileNetV2, EfficientNet Lite, FPN, and Fast-SCNN were compared against a U-Net baseline using the INbreast dataset with 5-fold cross-validation. Performance was assessed using Dice score, Intersection over Union (IoU), and Recall, alongside model complexity. MobileNetV2 with Squeeze-and-Excitation (SCSE) achieved the best performance, with a Dice score of 0.5766 while using approximately 75% fewer parameters than U-Net. Cross-dataset evaluation on the DMID dataset showed reduced accuracy due to domain shift but preserved recall. These results demonstrate that lightweight architectures offer a practical balance between performance and efficiency for deployable CAD systems.

Accurate whole-cell and nuclear segmentation is essential for precision pathology and spatial omics, yet routine hematoxylin and eosin (H&E) staining provides limited cytoplasmic contrast, restricting analyses to nuclei. Multiplex immunofluorescence (mIF) facilitates precise whole-cell delineation but remains constrained by cost and accessibility. We introduce VitaminP, a cross-modal learning framework enabling whole cell segmentation from H&E images. By learning from paired H&E-mIF data, VitaminP transfers molecular boundary information from mIF to overcome cytoplasmic contrast in H&E, establishing cross-modal supervision as a general strategy for recovering missing biological structure. We train VitaminP on 14 public datasets covering 34 cancer types and over 7 million instances, integrating publicly available labels with extensive annotations generated in this study, forming one of the largest resources for segmentation. VitaminP outperforms four state-of-the-art methods and generalizes to unseen datasets, including an in-house dataset spanning 24 rare cancer types. We further developed VitaminPScope, an open-source platform providing an interface for scalable inference and enabling broad adoption.

Disease progression varies with age and is influenced by underlying genetic, biochemical, and hormonal etiologies, suggesting the need for tailored monitoring, care, and medication beyond standard clinical guidelines. Specifically, in autoimmune diseases like type 1 diabetes (T1D), where patients depend on exogenous insulin to compensate for insulin deficiency, medication dosing and the physiological response reflected in vital signs can differ. Insulin therapy can lead to hypoglycemia, a dangerous condition characterized by decreased blood glucose levels ($\leq$70). This risk can be mitigated through improved diabetes management supported by data analytics. Notably, leveraging data from continuous glucose monitoring (CGM) devices, hypoglycemia onset can be predicted. However, while glucose variability, auto-antibody levels, and hypoglycemia occurrence differ across age groups, hypoglycemia classification most often only relies on population-based models specialized in specific age ranges. In this work, we classify hypoglycemia 0, 5-15, 20-45, and 50-120 minutes before onset using DiaData, a large CGM dataset of patients with T1D ranging from children to seniors. In particular, we investigate: 1) the generalizability of a population-based model including all age groups, 2) the impact of age-segmented models trained separately per age group, and 3) the effect of model individualization through transfer learning. The results show that a global population-based model yields similar or superior performance compared to age-segmented models. These findings suggest that data from children, teenagers, and adults can be combined for training models on hypoglycemia classification. While glucose variation differs across age groups, short-term hypoglycemic patterns are similar. However, data of children obtain their best recall with age specialized model.

Deep learning-based nuclei segmentation and classification in pathology images typically rely on large-scale pixel-level manual annotations, which are costly and difficult to obtain across diverse tissues and staining conditions. To address this limitation, we propose a framework that leverages spatial transcriptomics (ST) data as supervision for nuclei segmentation and classification. By incorporating cell-level ST data, we obtain gene expression profiles and corresponding nuclear masks from histopathological images. Gene expression profiles are converted into cell-type labels and used as training data for image-based classification. Because existing gene expression-based cell-type classification methods are not designed for image recognition, we introduce an image-oriented classification approach that bridges gene expression-based cell typing and image-based cell classification. To evaluate generalization, we conduct segmentation experiments on previously unseen organs and compare our method with conventional supervised models. Despite being trained on fewer organ types, our framework achieves higher segmentation accuracy, demonstrating strong transferability. Classification experiments further show consistent improvements over existing approaches.

We present CRC-SAM, a unified framework for colorectal cancer segmentation across colonoscopy, CT, and histopathology images. Unlike prior single-modality methods, CRC-SAM provides consistent, modality-agnostic segmentation throughout the clinical workflow. Built on MedSAM, it incorporates low-rank adaptation (LoRA) layers into a frozen encoder, enabling efficient domain transfer to underrepresented modalities with minimal trainable parameters. Experiments on MSD-Colon, CVC-ClinicDB, and EBHI-Seg demonstrate superior performance across modalities, outperforming state-of-the-art baselines and highlighting the effectiveness of lightweight LoRA adaptation for foundation-model-based colorectal cancer analysis.

High-performance semantic segmentation has achieved significant progress in recent years, often driven by increasingly large backbones and higher computational budgets. While effective, such approaches introduce substantial computational overhead and limit accessibility under constrained hardware settings. In this paper, we propose DGM-Net (Directional Geometric Mamba Network), an efficient architecture that improves modeling capability through structural design rather than increasing model capacity. We introduce Directional Geometric Mamba (G-Mamba), a linear-complexity O(N) operator as an alternative to conventional context modeling modules such as ASPP and PPM. To further enhance structural awareness in state space model (SSM)-based modeling, we design the DGM-Module, which extracts centripetal flow fields and topological skeletons to guide the scanning process and improve boundary preservation. Without relying on large-scale pretraining or heavy backbone scaling, DGM-Net achieves 80.8% mIoU within 28k iterations, 82.3% mIoU on Cityscapes test set, and 45.24% mIoU on ADE20K. In addition, the model maintains stable performance under constrained hardware settings (e.g., batch size of 2 on 8GB VRAM), highlighting its efficiency and practicality. These results demonstrate that incorporating geometric guidance into SSM-based architectures provides an effective and resource-efficient direction for semantic segmentation.

Segmentation is central to clinical diagnosis and monitoring, yet the reliability of modern foundation models in medical imaging still depends on the availability of precise prompts. The Segment Anything Model (SAM) offers powerful zero-shot capabilities, although it collapses under the weak, generic, and noisy prompts that dominate real clinical workflows. In practice, annotations such as centerline points are coarse and ambiguous, often drifting across neighboring anatomy and misguiding SAM toward inconsistent or incomplete masks. We introduce SPD, a Saliency-Guided Prompt Distillation framework that converts these unreliable cues into robust guidance. SPD first learns data-driven anatomical priors through a lightweight saliency head to obtain confident localization maps. These priors then drive Contextual Prompt Distillation, which validates and enriches noisy prompts using cues from anatomically adjacent slices, producing a consensus prompt set that matches the behavior of expert reasoning. A Pairwise Slice Consistency objective further enforces local anatomical coherence during segmentation. Experiments on four challenging MRI and CT benchmarks demonstrate that SPD consistently outperforms existing SAM adaptations and supervised baselines, delivering large gains in both region-based and boundary-based metrics. SPD provides a practical and principled path toward reliable foundation model deployment in clinical environments where only imperfect prompts are available.

Semi-supervised learning addresses label scarcity and high annotation costs in medical image segmentation by exploiting the latent information in unlabeled data to enhance model performance. Traditional discriminative segmentation relies on segmentation masks, neglecting feature-level distribution constraints. This limits robust semantic representation learning and adaptive modeling of unlabeled data in scenarios with few labels. To address these limitations, we propose SemiGDA, a novel Generative Dual-distribution Alignment framework for semi-supervised medical image segmentation. Our SemiGDA overcomes the reliance of discriminative methods on large labeled datasets by aligning feature and semantic distributions to boost semantic learning and scene adaptability. Specifically, we propose a Dual-distribution Alignment Module (DAM), which employs two structurally distinct encoders to model image and mask feature distributions. It enforces their alignment in the latent space via distributional constraints, establishing structured feature consistency. Moreover, we design a Consistency-Driven Skip Adapter (CDSA) strategy, which introduces dual skip adapters (Image and Mask) to fuse multi-scale features via skip connections. Using a consistency loss, CDSA enhances cross-branch semantic alignment and reinforces fine-grained semantic consistency. Experimental results on diverse medical datasets show that our method outperforms other state-of-the-art semi-supervised segmentation methods. Code is released at: https://github.com/taozh2017/SemiGDA.

This work introduces DyABD, a novel and complex benchmark dataset of dynamic abdominal MRIs from patients with abdominal hernias and associated high quality abdominal muscle annotations. DyABD is the first-of-its-kind in four key ways; (1) it proposes the first abdominal muscle segmentation task, (2) the dynamic MRIs are acquired whilst the patients perform various exercises, introducing extreme anatomical variability, making it one of the most challenging segmentation datasets to date, (3) it includes both pre and post corrective MRIs and (4) DyABD promotes clinical research into the high recurrence rates of abdominal hernias. Beyond dataset introduction, this work provides a comprehensive evaluation of the generalisation capabilities of existing segmentation models across Supervised, Few Shot and Zero Shot paradigms on the unseen DyABD dataset. This work reveals that there is still room for substantial improvement in the field of medical image segmentation, with the majority of techniques achieving a Dice Coefficient of 0.82. This work therefore sheds light on the true progress of the field and redefines the benchmark for progress in medical image segmentation.

A levelset free but a hybrid image segmentation approach based on a modified version of the piece wise constant shape gradient of an Mumford Shah shape functional and a repulsive function is considered. The segmentation is performed a non-local shape based through an evolution of discrete curves driven by a non local shape based energy to segment images containing disjoint regions and multiple boundaries. This formulation has a novel additional component as a multivariable function dependent on a few sampled points of the curves that handles the occurrence of self intersection during boundary curves evolution. The method is applied to a few gray scale and color images, including images with nested structures and astronomical objects. The results indicate effective segmentation in complex scenarios with absolute control on the topology of the segments and self-intersections of the boundaries

Reliable object perception is necessary for general-purpose service robots. Open-vocabulary detectors struggle to generalize beyond a few classes and fully supervised training of object detectors requires time-intensive annotations. We present a semi-supervised label propagation approach for household object segmentation. A segment proposer generates class-agnostic masks, and an ensemble of Hopfield networks assigns labels by learning representative embeddings in complementary foundation model embedding spaces (CLIP, ViT, Theia). Our approach scales to 50 object classes with limited annotation overhead and can automatically label 60% of the data in a RoboCup@Home setting, where preparation time is severely constrained. Dataset and code are publicly available at https://github.com/ais-bonn/label_propagation.

We present Sapiens2, a model family of high-resolution transformers for human-centric vision focused on generalization, versatility, and high-fidelity outputs. Our model sizes range from 0.4 to 5 billion parameters, with native 1K resolution and hierarchical variants that support 4K. Sapiens2 substantially improves over its predecessor in both pretraining and post-training. First, to learn features that capture low-level details (for dense prediction) and high-level semantics (for zero-shot or few-label settings), we combine masked image reconstruction with self-distilled contrastive objectives. Our evaluations show that this unified pretraining objective is better suited for a wider range of downstream tasks. Second, along the data axis, we pretrain on a curated dataset of 1 billion high-quality human images and improve the quality and quantity of task annotations. Third, architecturally, we incorporate advances from frontier models that enable longer training schedules with improved stability. Our 4K models adopt windowed attention to reason over longer spatial context and are pretrained with 2K output resolution. Sapiens2 sets a new state-of-the-art and improves over the first generation on pose (+4 mAP), body-part segmentation (+24.3 mIoU), normal estimation (45.6% lower angular error) and extends to new tasks such as pointmap and albedo estimation. Code: https://github.com/facebookresearch/sapiens2

Lung adenocarcinoma (LUAD) grading depends on accurately identifying growth patterns, which are indicators of prognosis and can influence treatment decisions. Common deep learning approaches to determine the predominant pattern rely on patch-level classification or segmentation, requiring extensive annotations. This study proposes an attention-based multiple instance learning (ABMIL) framework to predict the predominant LUAD growth pattern at the whole slide level to reduce annotation burden. Our approach integrates pretrained pathology foundation models as patch encoders, used either frozen or fine-tuned on annotated patches, to extract discriminative features that are aggregated through attention mechanisms. Experiments show that fine-tuned encoders improve performance, with Prov-GigaPath achieving the highest agreement (\k{appa} = 0.699) under ABMIL. Compared to simple patch-aggregation baselines, ABMIL yields more robust predictions by leveraging slide-level supervision and spatial attention. Future work will extend this framework to estimate the full distribution of growth patterns and validate performance on external cohorts.

High-quality digital terrain models derived from airborne laser scanning (ALS) data are essential for a wide range of geospatial analyses, and their generation typically relies on robust ground filtering (GF) to separate point clouds across diverse landscapes into ground and non-ground parts. Although current deep-learning-based GF methods have demonstrated impressive performance, especially in specific challenging terrains, their cross-scene generalization remains limited by two persistent issues: the context-detail dilemma in large-scale processing due to limited computational resources, and the random misclassification of tall objects arising from classification-only optimization. To overcome these limitations, we propose SparseGF, a height-aware sparse segmentation framework enhanced with context compression. It is built upon three key innovations: (1) a convex-mirror-inspired context compression module that condenses expansive contexts into compact representations while preserving central details; (2) a hybrid sparse voxel-point network architecture that effectively interprets compressed representations while mitigating compression-induced geometric distortion; and (3) a height-aware loss function that explicitly enforces topographic elevation priors during training to suppress random misclassification of tall objects. Extensive evaluations on two large-scale ALS benchmark datasets demonstrate that SparseGF delivers robust GF across urban to natural terrains, achieving leading performance in complex urban scenes, competitive results on mixed terrains, and moderate yet non-catastrophic accuracy in densely forested steep areas. This work offers new insights into deep-learning-based GF research and encourages further exploration toward truly cross-scene generalization for large-scale environmental monitoring.

Pancreatic tumor segmentation in contrast-enhanced computed tomography (CT) is clinically important yet technically challenging: lesions are often small, heterogeneous, and easily confused with surrounding soft tissue, and models that perform well on one cohort frequently degrade under cohort shift. Our goal is to improve cross-cohort generalization while keeping the model architecture simple, efficient, and practical for 3D CT segmentation. We introduce PanGuide3D, a cohort-robust architecture with a shared 3D encoder, a pancreas decoder that predicts a probabilistic pancreas map, and a tumor decoder that is explicitly conditioned on this pancreas probability at multiple scales via differentiable soft gating. To capture long-range context under distribution shift, we further add a lightweight Transformer bottleneck in the U-Net bottleneck representation. We evaluate cohort transfer by training on the PanTS (Pancreatic Tumor Segmentation) cohort and testing both in-cohort (PanTS) and out-of-cohort on MSD (Medical Segmentation Decathlon) Task07 Pancreas, using matched preprocessing and training protocols across strong baselines. We collect voxel-level segmentation metrics, patient-level tumor detection, subgroup analyses by tumor size and anatomical location, volume-conditioned performance analyses, and calibration measurements to assess reliability. Across the evaluated models, PanGuide3D achieves the best overall tumor performance and shows improved cross-cohort generalization, particularly for small tumors and challenging anatomical locations, while reducing anatomically implausible false positives. These findings support probabilistic anatomical conditioning as a practical strategy for improving cross-cohort robustness in an end-to-end model and suggest potential utility for contouring support, treatment planning, and multi-institutional studies.

Liver cancer, especially hepatocellular carcinoma (HCC), imposes a substantial global disease burden. Accurate diagnosis and prognostic assessment directly influence treatment selection and patient survival, and pathological examination remains the gold standard for liver cancer diagnosis. Identifying diverse tissue components and pathological subtypes on histopathology slides is crucial for estimating postoperative recurrence risk and overall prognosis. However, most publicly available resources are still provided at the whole-slide image (WSI) level, and well-annotated datasets for fine-grained tissue component identification in liver cancer are scarce, which hinders reproducible model development and the deployment of quantitative analysis tools. To address this gap, we release HepatoBench, a patch-level image database for liver cancer with annotations for seven key tissue categories. Based on HepatoBench, we train and open-source a deep learning classification model as a tissue recognition tool. Furthermore, we train a WSI-level tumor/non-tumor segmentation model to automatically localize lesion regions across entire slides. By integrating the patch-level tissue classifier with the WSI-level segmentation model, we build HepatoQuant, an end-to-end, disease-specific regional quantification tool for liver cancer, enabling a unified workflow from WSIs to tissue composition parsing and quantitative statistics. We also open-source HepatoBench, the benchmarking protocol, and supporting tools, providing a solid foundation for automated regional quantification and fair method comparison in liver cancer pathology.

Transformer architectures, including nnFormer,have demonstrated promising results in volumetric medical image segmentation by being able to capture long-range spatial interactions. Although they have high performance, these models need large quantities of labeled training data and are also likely to overfit and become training unstable. This is a serious practical problem because it is not only time-consuming but also expensive to obtain medical images that are annotated by experts. Moreover, fully supervised traditional training pipelines do not take advantage of the available large amounts of unlabeled medical imaging data that can be easily obtained in the clinics. We have solved these drawbacks by advancing the efficiency of the nnFormer with a self-supervised pretraining framework, which is based on the Masked Autoencoders (MAE). In this method, the model is pretrained on unlabeled volumetric medical images to reconstruct randomly masked parts of the input. This allows the encoder to learn meaningful anatomical and structural representations . The encoder is then further fine-tuned on a labeled dataset on the downstream segmentation task. Conducted Experiment shows that the offered method leads to a higher segmentation performance on the count of Dice score, a quicker convergence rate on the course of the fine-tuning procedure, and a superior generalization on the basis of limited labeled data . These findings validate that self-supervised learning combined with transformer-based segmentation models is an appropriate approach to the problem of data shortage in medical image analysis.

Recent segmentation models have demonstrated promising efficiency by aggressively reducing parameter counts and computational complexity. However, these models often struggle to accurately delineate fine lesion boundaries and texture patterns essential for early skin cancer diagnosis and treatment planning. In this paper, we propose MambaLiteUNet, a compact yet robust segmentation framework that integrates Mamba state space modeling into a U-Net architecture, along with three key modules: Adaptive Multi-Branch Mamba Feature Fusion (AMF), Local-Global Feature Mixing (LGFM), and Cross-Gated Attention (CGA). These modules are designed to enhance local-global feature interaction, preserve spatial details, and improve the quality of skip connections. MambaLiteUNet achieves an average IoU of 87.12% and average Dice score of 93.09% across ISIC2017, ISIC2018, HAM10000, and PH2 benchmarks, outperforming state-of-the-art models. Compared to U-Net, our model improves average IoU and Dice by 7.72 and 4.61 points, respectively, while reducing parameters by 93.6% and GFLOPs by 97.6%. Additionally, in domain generalization with six unseen lesion categories, MambaLiteUNet achieves 77.61% IoU and 87.23% Dice, performing best among all evaluated models. Our extensive experiments demonstrate that MambaLiteUNet achieves a strong balance between accuracy and efficiency, making it a competitive and practical solution for dermatological image segmentation. Our code is publicly available at: https://github.com/maklachur/MambaLiteUNet.

While current deep learning models achieve high performance by learning statistical correlations from vast datasets,which stands in stark contrast to human learning. They lack the flexibility of humans-particularly preverbal infants-to autonomously acquire the underlying structure of the world from limited experience and adapt to novel situations. In this study, we propose an unsupervised representation learning method based on a hierarchical relationship in group operations, rather than statistical independence, aiming to build a computational model of the cognitive development of infants. The proposed model features an integrated architecture that simultaneously performs object segmentation and the extraction of motion laws from dynamic image sequences. By introducing the Homomorphism from algebra as a structural constraint within a neural network, the model structurally separates pixel-level changes into meaningful, decomposed transformation components, such as translation and deformation. Using interaction scenes (chasing and evading tasks) based on developmental science findings, we experimentally demonstrate that the model can segment multiple objects into individual slots without any ground-truth labels. Furthermore, we confirmed that relative movements between objects, such as approaching or receding, are accurately mapped and structured into a one-dimensional additive latent space. These results suggest that by introducing algebraic geometric constraints rather than relying solely on statistical correlation learning, physically interpretable "disentangled representations" can be acquired. This study contributes to the understanding of the process by which infants internalize environmental laws as structures and provides a new perspective for constructing artificial systems with developmental intelligence.

We propose Semantic-Fast-SAM (SFS), a semantic segmentation framework that combines the Fast Segment Anything model with a semantic labeling pipeline to achieve real-time performance without sacrificing accuracy. FastSAM is an efficient CNN-based re-implementation of the Segment Anything Model (SAM) that runs much faster than the original transformer-based SAM. Building upon FastSAM's rapid mask generation, we integrate a Semantic-Segment-Anything (SSA) labeling strategy to assign meaningful categories to each mask. The resulting SFS model produces high-quality semantic segmentation maps at a fraction of the computational cost and memory footprint of the original SAM-based approach. Experiments on Cityscapes and ADE20K benchmarks demonstrate that SFS matches the accuracy of prior SAM-based methods (mIoU ~ 70.33 on Cityscapes and 48.01 on ADE20K) while achieving approximately 20x faster inference than SSA in the closed-set setting. We also show that SFS effectively handles open-vocabulary segmentation by leveraging CLIP-based semantic heads, outperforming recent open-vocabulary models on broad class labeling. This work enables practical real-time semantic segmentation with the "segment-anything" capability, broadening the applicability of foundation segmentation models in robotics scenarios. The implementation is available at https://github.com/KBH00/Semantic-Fast-SAM.

Flow matching has recently emerged as a principled framework for learning continuous-time transport maps, enabling efficient ODE-based sampling without relying on stochastic diffusion processes. While generative modeling has shown promise for medical image segmentation, particularly in capturing uncertainty and complex anatomical variability, existing approaches are predominantly based on diffusion models, which require iterative sampling and incur substantial computational overhead. In this work, we propose MedFlowSeg, a conditional flow matching framework that formulates medical image segmentation as learning a time-dependent vector field that transports a simple prior distribution to the target segmentation distribution. Compared to diffusion-based methods, our formulation enables more efficient inference through solving an ordinary differential equation, while preserving the flexibility of generative modeling. To effectively incorporate conditional information, we introduce a dual-conditioning mechanism. Specifically, we propose a Dual-Branch Spatial Attention (DB-SA) module to inject multi-frequency structural priors, and a Frequency-Aware Attention (FA-Attention) module to model interactions between spatial and spectral representations via discrepancy-aware fusion and time-dependent modulation. These components improve the alignment between noisy intermediate states and clean semantic features, leading to better structural consistency and boundary delineation. We conduct extensive experiments across multiple medical imaging modalities, where MedFlowSeg consistently outperforms prior state-of-the-art (SOTA) baselines, including diffusion-based and flow-based methods.

SAM3 advances open-vocabulary semantic segmentation by introducing a prompt-driven mask generation paradigm. However, in multi-class open-vocabulary scenarios, masks generated independently from different category prompts lack a unified and inter-class comparable evidence scale, often resulting in overlapping coverage and unstable competition. Moreover, synonymous expressions of the same concept tend to activate inconsistent semantic and spatial evidence, leading to intra-class drift that exacerbates inter-class conflicts and compromises overall inference stability. To address these issues, we propose CoCo-SAM3 (Concept-Conflict SAM3), which explicitly decouples inference into intra-class enhancement and inter-class competition. Our method first aligns and aggregates evidence from synonymous prompts to strengthen concept consistency. It then performs inter-class competition on a unified comparable scale, enabling direct pixel-wise comparisons among all candidate classes. This mechanism stabilizes multi-class inference and effectively mitigates inter-class conflicts. Without requiring any additional training, CoCo-SAM3 achieves consistent improvements across eight open-vocabulary semantic segmentation benchmarks.

Accurate medical image segmentation requires both long-range contextual reasoning and precise boundary delineation, a task where existing transformer- and diffusion-based paradigms are frequently bottlenecked by quadratic computational complexity and prohibitive inference latency. We propose RF-HiT, a Rectified Flow Hierarchical Transformer that integrates an Hourglass Transformer backbone with a multi-scale hierarchical encoder for anatomically guided feature conditioning. Unlike prior diffusion-based approaches that rely on hundreds of denoising steps, RF-HiT leverages rectified flow with efficient transformer blocks, achieving linear complexity and requiring only a few discretization steps. The model further fuses conditioning features at each resolution via learnable interpolation, enabling effective multi-scale feature integration with minimal computational overhead. As a result, RF-HiT achieves a strong efficiency-performance trade-off, requiring only 10.14 GFLOPs, 13.6M parameters, and inference in as few as 3 steps. Despite its compact design, RF-HiT attains 91.27% mean Dice on ACDC and 87.40% on BraTS 2021, achieving performance comparable to or exceeding that of significantly more intensive architectures. These results suggest that RF-HiT is a promising, computationally efficient foundation for clinical image segmentation.

Automatic pancreas segmentation is fundamental to abdominal MRI analysis, yet deep learning models trained on one MRI sequence often fail catastrophically when applied to another-a challenge that has received little systematic investigation. We introduce CrossPan, a multi-institutional benchmark comprising 1,386 3D scans across three routinely acquired sequences (T1-weighted, T2-weighted, and Out-of-Phase) from eight centers. Our experiments reveal three key findings. First, cross-sequence domain shifts are far more severe than cross-center variability: models achieving Dice scores above 0.85 in-domain collapse to near-zero (<0.02) when transferred across sequences. Second, state-of-the-art domain generalization methods provide negligible benefit under these physics-driven contrast inversions, whereas foundation models like MedSAM2 maintain moderate zero-shot performance through contrast-invariant shape priors. Third, semi-supervised learning offers gains only under stable intensity distributions and becomes unstable on sequences with high intra-organ variability. These results establish cross-sequence generalization-not model architecture or center diversity-as the primary barrier to clinically deployable pancreas MRI segmentation. Dataset and code are available at https://crosspan.netlify.app/.

Visual state-space models (SSMs) are increasingly promoted as efficient alternatives to Vision Transformers, yet their practical advantages remain unclear under fair comparison because existing studies rarely isolate encoder effects from decoder and training choices. We present a strictly controlled benchmark of representative visual SSM families, including VMamba, MambaVision, and Spatial-Mamba, for remote-sensing semantic segmentation, in which only the encoder varies across experiments. Evaluated on LoveDA and ISPRS Potsdam under a unified 4-stage feature interface and a fixed lightweight decoder, the benchmark reveals three main findings, intra-family scaling yields only modest gains, cross-domain generalization is strongly asymmetric, and boundary delineation is the dominant failure mode under distribution shift. Although visual SSMs achieve favorable accuracy-efficiency trade-offs relative to the controlled CNN and Transformer baselines considered here, the results suggest that future improvements are more likely to come from robustness-oriented design and boundary-aware decoding than from encoder scaling alone. By isolating encoder behavior under a unified and reproducible protocol, this study establishes a practical reference benchmark for the design and evaluation of future Mamba-based segmentation backbones

Automated 3D segmentation of prostate lesions from biparametric MRI (bp-MRI) is essential for reliable algorithmic analysis, but achieving high precision remains challenging. Volumetric methods must combine multiple modalities while ensuring anatomical consistency, but current models struggle to integrate cross-modal information reliably. While vision-language models (VLMs) are replacing the currently used architectural designs, they still lack the fine-grained, lesion-level semantics required for effective localized guidance. To address these limitations, we propose a new multi-encoder U-Net architecture incorporating three key innovations: (1) an alignment loss that enhances foreground text-image similarity to inject lesion semantics; (2) a heatmap loss that calibrates the similarity map and suppresses spurious background activations; and (3) a final-stage, confidence-gated multi-head cross-attention refiner that performs localized boundary edits in high-confidence regions. A phase-scheduled training regime stabilizes the optimization of these components. Our method consistently outperforms prior approaches, establishing a new state-of-the-art on the PI-CAI dataset through enhanced multi-modal fusion and localized text guidance. Our code is available at https://github.com/NUBagciLab/Prostate-Lesion-Segmentation.

A key challenge in segmentation in digital histopathology is inter- and intra-stain variations as it reduces model performance. Labelling each stain is expensive and time-consuming so methods using stain transfer via CycleGAN, have been developed for training multi-stain segmentation models using labels from a single stain. Nevertheless, CycleGAN tends to introduce noise during translation because of the one-to-many nature of some stain pairs, which conflicts with its cycle consistency loss. To address this, we propose the Domain Shift Aware CycleGAN, which reduces the presence of such noise. Furthermore, we evaluate several advances from the field of machine learning aimed at resolving similar problems and compare their effectiveness against DSA-CycleGAN in the context of multi-stain glomeruli segmentation. Experiments demonstrate that DSA-CycleGAN not only improves segmentation performance in glomeruli segmentation but also outperforms other methods in reducing noise. This is particularly evident when translating between biologically distinct stains. The code is publicly available at https://github.com/zeeshannisar/DSA-CycleGAN.

Recent advances in semantic correspondence rely on dual-encoder architectures, combining DINOv2 with diffusion backbones. While accurate, these billion-parameter models generalize poorly beyond training keypoints, revealing a gap between benchmark performance and real-world usability, where queried points rarely match those seen during training. Building upon DINOv2, we introduce MARCO, a unified model for generalizable correspondence driven by a novel training framework that enhances both fine-grained localization and semantic generalization. By coupling a coarse-to-fine objective that refines spatial precision with a self-distillation framework, which expands sparse supervision beyond annotated regions, our approach transforms a handful of keypoints into dense, semantically coherent correspondences. MARCO sets a new state of the art on SPair-71k, AP-10K, and PF-PASCAL, with gains that amplify at fine-grained localization thresholds (+8.9 PCK@0.01), strongest generalization to unseen keypoints (+5.1, SPair-U) and categories (+4.7, MP-100), while remaining 3x smaller and 10x faster than diffusion-based approaches. Code is available at https://github.com/visinf/MARCO .

Is Segment Anything Model 3 (SAM3) capable in segmenting Any Pathology Images? Digital pathology segmentation spans tissue-level and nuclei-level scales, where traditional methods often suffer from high annotation costs and poor generalization. SAM3 introduces Promptable Concept Segmentation, offering a potential automated interface via text prompts. With this work, we propose a systematic evaluation protocol to explore the capability space of SAM3 in a structured manner. Specifically, we evaluate SAM3 under different supervision settings including zero-shot, few-shot, and supervised with varying prompting strategies. Our extensive evaluation on pathological datasets including NuInsSeg, PanNuke and GlaS, reveals that: (1) text-only prompts poorly activate nuclear concepts; (2) performance is highly sensitive to visual prompt types and budgets; (3) few-shot learning offers gains, but SAM3 lacks robustness against visual prompt noise; and (4) a significant gap persists between prompt-based usage and task-trained adapter-based reference. Our study delineates SAM3's boundaries in pathology image segmentation and provides practical guidance on the necessity of pathology domain adaptation.

Visual prompting has emerged as a powerful method for adapting pre-trained models to new domains without updating model parameters. However, existing prompting methods typically optimize a single prompt per domain and apply it uniformly to all inputs, limiting their ability to generalize under intra and inter-domain variability, which is especially critical in the medical field. To address this, we propose APEX, an Adaptive Prompt EXtraction framework that retrieves input-specific prompts from a learnable prompt memory. The memory stores diverse, domain-discriminative prompt representations and is queried via domain features extracted from the Fourier spectrum. To learn robust and discriminative domain features, we introduce a novel Low-Frequency Feature Contrastive (LFC) learning framework that clusters representations from the same domain while separating those from different domains. Extensive experiments on two medical segmentation tasks demonstrate that APEX significantly improves generalization across both seen and unseen domains. Furthermore, it complements any existing backbones and consistently enhances performance, confirming its effectiveness as a plug-and-play prompting solution in medical fields. The code is available at https://github.com/cetinkayaevren/apex/

Increasingly advanced data augmentation techniques have greatly aided clinical medical research, increasing data diversity and improving model generalization capabilities. Although most current basic models exhibit strong generalization abilities, image quality varies due to differences in equipment and operators. To address these challenges, we present SegTTA, a framework that improves medical image segmentation without model retraining by combining four augmentations (Gamma correction, Contrast enhancement, Gaussian blur, Gaussian noise) with weighted voting across multiple MedSAM2 checkpoints. Experiments demonstrate consistent improvements across three diverse datasets: healthy uterus segmentation, uterine myoma detection, and multi class hepatic structure segmentation. Ablation studies reveal that large organs benefit from intensity augmentations while small lesions require noise augmentations. The voting threshold controls the coverage precision trade off, enabling task specific optimization for different clinical requirements. Ultimately, on a multiclass hepatic vessel dataset, compared to MedSAM2 baselines, our method achieves an increase of 1.6 in mIoU and 1.9 in aIoU, along with a reduction of approximately 2.0 in HD95. Code will be available at https://github.com/AIGeeksGroup/SegTTA.

Large segmentation foundation models such as the Segment Anything Model (SAM) have reshaped promptable segmentation in natural images, and recent efforts have extended these models to medical images and volumetric settings. However, directly transferring a 3D SAM-style model to lesion segmentation remains challenging due to (i) weak spatial representational capacity for small, irregular targets in intermediate features, and (ii) extreme foreground-background imbalance in 3D volumes.We propose SGP-SAM, a self-gated prompting framework for efficient and effective transfer to 3D lesion segmentation. Our key component, the Self-Gated Prompting Module (SGPM), performs conditional multi-scale spatial enhancement: a lightweight multi-channel gating unit predicts whether the current features require additional multi-scale fusion, and only then activates a Multi-Scale Feature Fusion Block to enrich spatial context. To further address small-lesion learning, we design a Zoom Loss that up-weights lesion-focused supervision by combining Dice and a voxel-balanced focal term.Experiments on MSD Liver Tumor and MSD Brain Tumor (enhancing tumor) show consistent gains over strong transfer baselines based on SAM-Med3D. On MSD Liver Tumor, SGP-SAM improves mDice by 7.3% over fine-tuning.

WeatherSeg, an advanced semi-supervised segmentation framework, addresses autonomous driving's environmental perception challenges in adverse weather while reducing annotation costs. This framework integrates a Dual Teacher-Student Weight-Sharing Model (DTSWSM) that enables knowledge distillation from weather-affected images, and a Classifier Weight Updating Attention Mechanism (CWUAM) that dynamically adjusts classifier weights based on environmental attributes. Comprehensive evaluations demonstrate that WeatherSeg significantly outperforms baseline models in both accuracy and robustness across various weather conditions, including clear, rainy, cloudy, and foggy scenarios, establishing it as an effective solution for all-weather semantic segmentation in autonomous driving and related applications.

Semantic segmentation in hyperbolic space enables compact modeling of hierarchical structure while providing inherent uncertainty quantification. Prior approaches predominantly rely on the Poincaré ball model, which suffers from numerical instability, optimization, and computational challenges. We propose a novel, tractable, architecture-agnostic semantic segmentation framework (pixel-wise and mask classification) in the hyperbolic Lorentz model. We employ text embeddings with semantic and visual cues to guide hierarchical pixel-level representations in Lorentz space. This enables stable and efficient optimization without requiring a Riemannian optimizer, and easily integrates with existing Euclidean architectures. Beyond segmentation, our approach yields free uncertainty estimation, confidence map, boundary delineation, hierarchical and text-based retrieval, and zero-shot performance, reaching generalized flatter minima. We introduce a novel uncertainty and confidence indicator in Lorentz cone embeddings. Further, we provide analytical and empirical insights into Lorentz optimization via gradient analysis. Extensive experiments on ADE20K, COCO-Stuff-164k, Pascal-VOC, and Cityscapes, utilizing state-of-the-art per-pixel classification models (DeepLabV3 and SegFormer) and mask classification models (mask2former and maskformer), validate the effectiveness and generality of our approach. Our results demonstrate the potential of hyperbolic Lorentz embeddings for robust and uncertainty-aware semantic segmentation. Code is available at https://github.com/mxahan/Lorentz_semantic_segmentation.

Landslide detection from high resolution satellite imagery is a critical task for disaster response and risk assessment, yet the relative effectiveness of modern segmentation architectures and finetuning strategies for this problem remains insufficiently understood. In this work, we present a systematic benchmarking study of convolutional neural networks, transformer based segmentation models, and large pre-trained foundation models for landslide detection. Using the Globally Distributed Coseismic Landslide Dataset (GDCLD) dataset, we evaluate representative CNN- and transformer-based segmentation models alongside large pretrained foundation models under consistent training and evaluation protocols. In addition, we compare full fine-tuning with parameter-efficient fine-tuning methods, including LoRA and AdaLoRA, to assess their performance efficiency tradeoffs. Experimental results show that transformer-based models achieve strong segmentation performance, while parameter efficient finetuning reduces trainable parameters by up to 95% with comparable accuracy to full finetuning. We further analyze generalization under distribution shift by comparing validation and held-out test performance.

Pancreatic ductal adenocarcinoma (PDAC) segmentation on contrast-enhanced CT is inherently ambiguous: inter-rater disagreement among experts reflects genuine uncertainty rather than annotation noise. Standard deep learning approaches assume a single ground truth, producing probabilistic outputs that can be poorly calibrated and difficult to interpret under such ambiguity. We present TwinTrack, a framework that addresses this gap through post-hoc calibration of ensemble segmentation probabilities to the empirical mean human response (MHR) -the fraction of expert annotators labeling a voxel as tumor. Calibrated probabilities are thus directly interpretable as the expected proportion of annotators assigning the tumor label, explicitly modeling inter-rater disagreement. The proposed post-hoc calibration procedure is simple and requires only a small multi-rater calibration set. It consistently improves calibration metrics over standard approaches when evaluated on the MICCAI 2025 CURVAS-PDACVI multi-rater benchmark.

Open-vocabulary semantic segmentation enables models to segment objects or image regions beyond fixed class sets, offering flexibility in dynamic environments. However, existing methods often rely on single-view images and struggle with spatial precision, especially under occlusions and near object boundaries. We propose SENSE, the first work on Stereo OpEN Vocabulary SEmantic Segmentation, which leverages stereo vision and vision-language models to enhance open-vocabulary semantic segmentation. By incorporating stereo image pairs, we introduce geometric cues that improve spatial reasoning and segmentation accuracy. Trained on the PhraseStereo dataset, our approach achieves strong performance in phrase-grounded tasks and demonstrates generalization in zero-shot settings. On PhraseStereo, we show a +2.9% improvement in Average Precision over the baseline method and +0.76% over the best competing method. SENSE also provides a relative improvement of +3.5% mIoU on Cityscapes and +18% on KITTI compared to the baseline work. By jointly reasoning over semantics and geometry, SENSE supports accurate scene understanding from natural language, essential for autonomous robots and Intelligent Transportation Systems.

Reliable uncertainty estimation is critical for medical image segmentation, where automated contours feed downstream quantification and clinical decision support. Many strong uncertainty methods require repeated inference, while efficient single-forward-pass alternatives often provide weaker failure ranking or rely on restrictive feature-space assumptions. We present $\textbf{SegWithU}$, a post-hoc framework that augments a frozen pretrained segmentation backbone with a lightweight uncertainty head. SegWithU taps intermediate backbone features and models uncertainty as perturbation energy in a compact probe space using rank-1 posterior probes. It produces two voxel-wise uncertainty maps: a calibration-oriented map for probability tempering and a ranking-oriented map for error detection and selective prediction. Across ACDC, BraTS2024, and LiTS, SegWithU is the strongest and most consistent single-forward-pass baseline, achieving AUROC/AURC of $0.9838/2.4885$, $0.9946/0.2660$, and $0.9925/0.8193$, respectively, while preserving segmentation quality. These results suggest that perturbation-based uncertainty modeling is an effective and practical route to reliability-aware medical segmentation. Source code is available at https://github.com/ProjectNeura/SegWithU.

This paper proposes a novel privacy-preserving semantic segmentation method that can use independent keys for each client and image. In the proposed method, the model creator and each client encrypt images using locally generated keys, and model training and inference are conducted on the encrypted images. To mitigate performance degradation, an image encryption method is applied to model training in addition to the generation of test images. In experiments, the effectiveness of the proposed method is confirmed on the Cityscapes dataset under the use of a vision transformer-based model, called SETR.

Purpose: Adaptive skip modules can improve medical image segmentation, but searching for them is computationally costly. Implantable Adaptive Cells (IACs) are compact NAS modules inserted into U-Net skip connections, reducing the search space compared with full-network NAS. However, the original IAC framework still requires a 200-epoch differentiable search for each backbone and dataset. Methods: We analyzed the temporal behavior of operations and edges within IAC cells during differentiable search on public medical image segmentation benchmarks. We found that operations selected in the final discrete cell typically emerge among the strongest candidates early in training, and their architecture parameters stabilize well before the final epoch. Based on this, we propose a Jensen--Shannon-divergence-based stability criterion that tracks per-edge operation-importance distributions and progressively prunes low-importance operations during search. The accelerated framework is called IAC-LTH. Results: Across four public benchmarks (ACDC, BraTS, KiTS, AMOS), several 2-D U-Net backbones, and a 2-D nnU-Net pipeline, IAC-LTH discovers IAC cells whose patient-level segmentation performance matches and sometimes slightly exceeds that of cells found by the original full-length search, while reducing wall-clock NAS cost by 3.7x to 16x across datasets and backbones. These results are consistent across architectures, benchmarks, and both non-augmented and augmented training settings, while preserving the gains of IAC-equipped U-Nets over strong attention-based and dense-skip baselines. Conclusion: Competitive IAC architectures can be identified from early-stabilizing operations without running the full search, making adaptive skip-module design more practical for medical image segmentation under realistic computational constraints.

Obstacle detection in railway environments is crucial for ensuring safety. However, very few studies address the problem using a complete, modular, and flexible system that can both detect objects in the scene and estimate their distance from the vehicle. Most works focus solely on detection, others attempt to identify the track, and only a few estimate obstacle distances. Additionally, evaluating these systems is challenging due to the lack of ground truth data. In this paper, we propose a modular and flexible framework that identifies the rail track, detects potential obstacles, and estimates their distance by integrating three neural networks for object detection, track segmentation, and monocular depth estimation with LiDAR point clouds. To enable a reliable and quantitative evaluation, the proposed framework is assessed using a synthetic dataset (SynDRA), which provides accurate ground truth annotations, allowing for direct performance comparison with existing methods. The proposed system achieves a mean absolute error (MAE) as low as 0.63 meters by integrating monocular depth maps with LiDAR, enabling not only accurate distance estimates but also spatial perception of the scene.

Myotubes are multinucleated muscle fibers serving as key model systems for studying muscle physiology, disease mechanisms, and drug responses. Mechanistic studies and drug screening thereby rely on quantitative morphological readouts such as diameter, length, and branching degree, which in turn require precise three-dimensional instance segmentation. Yet established pretrained biomedical segmentation models fail to generalize to this domain due to the absence of large annotated myotube datasets. We introduce a geometry-driven synthesis pipeline that models individual myotubes via polynomial centerlines, locally varying radii, branching structures, and ellipsoidal end caps derived from real microscopy observations. Synthetic volumes are rendered with realistic noise, optical artifacts, and CycleGAN-based Domain Adaptation (DA). A compact 3D U-Net with self-supervised encoder pretraining, trained exclusively on synthetic data, achieves a mean IPQ of 0.22 on real data, significantly outperforming three established zero-shot segmentation models, demonstrating that biophysics-driven synthesis enables effective instance segmentation in annotation-scarce biomedical domains.

Contrastive Language-Image Pre-training (CLIP) has demonstrated outstanding performance in global image understanding and zero-shot transfer through large-scale text-image alignment. However, the core of medical image analysis often lies in the fine-grained understanding of specific anatomical structures or lesion regions. Therefore, precisely comprehending region-of-interest (RoI) information provided by medical professionals or perception models becomes crucial. To address this need, we propose MedP-CLIP, a region-aware medical vision-language model (VLM). MedP-CLIP innovatively integrates medical prior knowledge and designs a feature-level region prompt integration mechanism, enabling it to flexibly respond to various prompt forms (e.g., points, bounding boxes, masks) while maintaining global contextual awareness when focusing on local regions. We pre-train the model on a meticulously constructed large-scale dataset (containing over 6.4 million medical images and 97.3 million region-level annotations), equipping it with cross-disease and cross-modality fine-grained spatial semantic understanding capabilities. Experiments demonstrate that MedP-CLIP significantly outperforms baseline methods in various medical tasks, including zero-shot recognition, interactive segmentation, and empowering multimodal large language models. This model provides a scalable, plug-and-play visual backbone for medical AI, combining holistic image understanding with precise regional analysis.

Robust segmentation of clinically significant prostate cancer (csPCa) on multi-parametric MRI must tolerate frequent degradation of its most informative diffusion sequences. Multi-modal fusion commonly employs learned modality gating under the assumption that gates implement per-sample modality quality routing -- rarely tested directly. We ask how gating behaves across backbone architectures. We systematically analyze modality-isolated gated fusion (MIGF) for csPCa segmentation on two backbones (nnU-Net and Mamba) using PI-CAI (n=1500), with cross-cohort validation on Prostate158 (n=158): a factorial ablation over gating, modality dropout, and deep supervision under 5-fold cross-validation (180 trained models), plus a gate-weight and counterfactual analysis of 30 trained gating models. Modality gating is backbone-conditional. On nnU-Net, adding gating reduces the ranking score (marginal effect -0.037; gating configurations p<0.05), whereas on Mamba the gating-plus-dropout configuration improves it (+0.024, p=0.037). Gate-weight analysis explains this: nnU-Net gates collapse into a near-static modality prior (across-case SD 0.0033), while Mamba gates retain sample-dependent variation (0.0365, ~11x larger, non-overlapping); replacing per-sample gates with their training-set mean leaves nnU-Net unchanged but degrades Mamba. Modality dropout is the only component beneficial on both backbones. Under cross-cohort shift, convolutional backbones collapse to case-level specificity near zero, whereas Mamba retains it (MIGF-Mamba highest, 0.31). Learned modality gates do not universally perform per-sample quality routing; their effective behavior is conditional on the backbone's inherent modality awareness. Among tested configurations, MIGF-Mamba is the most cross-cohort robust, and training-time modality dropout is the only component beneficial across both backbones.

Weakly supervised semantic segmentation aims to achieve pixel-level predictions using image-level labels. Existing methods typically entangle semantic recognition and object localization, which often leads models to focus exclusively on sparse discriminative regions. Although foundation models show immense potential, many approaches still follow the tightly coupled optimization paradigm, struggling to effectively alleviate pseudo-label noise and often relying on time-consuming multi-stage retraining or unstable end-to-end joint optimization. To address the above challenges, we present ModuSeg, a training-free weakly supervised semantic segmentation framework centered on explicitly decoupling object discovery and semantic assignment. Specifically, we integrate a general mask proposer to extract geometric proposals with reliable boundaries, while leveraging semantic foundation models to construct an offline feature bank, transforming segmentation into a non-parametric feature retrieval process. Furthermore, we propose semantic boundary purification and soft-masked feature aggregation strategies to effectively mitigate boundary ambiguity and quantization errors, thereby extracting high-quality category prototypes. Extensive experiments demonstrate that the proposed decoupled architecture better preserves fine boundaries without parameter fine-tuning and achieves highly competitive performance on standard benchmark datasets. Code is available at https://github.com/Autumnair007/ModuSeg.

Event-based cameras capture visual information as asynchronous streams of per-pixel brightness changes, generating sparse, temporally precise data. Compared to conventional frame-based sensors, they offer significant advantages in capturing high-speed dynamics while consuming substantially less power. Predicting future event representations from past observations is an important problem, enabling downstream tasks such as future semantic segmentation or object tracking without requiring access to future sensor measurements. While recent state-of-the-art approaches achieve strong performance, they often rely on computationally heavy backbones and, in some cases, large-scale pretraining, limiting their applicability in resource-constrained scenarios. In this work, we introduce E-TIDE, a lightweight, end-to-end trainable architecture for event-tensor prediction that is designed to operate efficiently without large-scale pretraining. Our approach employs the TIDE module (Temporal Interaction for Dynamic Events), motivated by efficient spatiotemporal interaction design for sparse event tensors, to capture temporal dependencies via large-kernel mixing and activity-aware gating while maintaining low computational complexity. Experiments on standard event-based datasets demonstrate that our method achieves competitive performance with significantly reduced model size and training requirements, making it well-suited for real-time deployment under tight latency and memory budgets.

Whole slide image (WSI) analysis heavily relies on multiple instance learning (MIL). While recent methods benefit from large-scale foundation models and advanced sequence modeling to capture long-range dependencies, they still struggle with two critical issues. First, directly applying frozen, task-agnostic features often leads to suboptimal separability due to the domain gap with specific histological tasks. Second, relying solely on global aggregators can cause over-smoothing, where sparse but critical diagnostic signals are overshadowed by the dominant background context. In this paper, we present ReconMIL, a novel framework designed to bridge this domain gap and balance global-local feature aggregation. Our approach introduces a Latent Space Reconstruction module that adaptively projects generic features into a compact, task-specific manifold, improving boundary delineation. To prevent information dilution, we develop a bi-stream architecture combining a Mamba-based global stream for contextual priors and a CNN-based local stream to preserve subtle morphological anomalies. A scale-adaptive selection mechanism dynamically fuses these two streams, determining when to rely on overall architecture versus local saliency. Evaluations across multiple diagnostic and survival prediction benchmarks show that ReconMIL consistently outperforms current state-of-the-art methods, effectively localizing fine-grained diagnostic regions while suppressing background noise. Visualization results confirm the models superior ability to localize diagnostic regions by effectively balancing global structure and local granularity.

Semantic segmentation for uncrewed aerial vehicles (UAVs) is fundamental for aerial scene understanding, yet existing RGB and RGB-T datasets remain limited in scale, diversity, and annotation efficiency due to the high cost of manual labeling and the difficulties of accurate RGB-T alignment on off-the-shelf UAVs. To address these challenges, we propose a scalable geometry-driven 2D-3D-2D paradigm that leverages multi-view redundancy in high-overlap aerial imagery to automatically propagate labels from a small subset of manually annotated RGB images to both RGB and thermal modalities within a unified framework. By lifting less than 3% of RGB images into a semantic 3D point cloud and rendering it into all views, our approach enables dense pseudo ground-truth generation across large image collections, automatically producing 97% of RGB labels and 100% of thermal labels while achieving 91% and 88% annotation accuracy without any 2D manual refinement. We further extend this 2D-3D-2D paradigm to cross-modal image registration, using 3D geometry as an intermediate alignment space to obtain fully automatic, strong pixel-level RGB-T alignment with 87% registration accuracy and no hardware-level synchronization. Applying our framework to existing geo-referenced aerial imagery, we construct SegFly, a large-scale benchmark with over 20,000 high-resolution RGB images and more than 15,000 geometrically aligned RGB-T pairs spanning diverse urban, industrial, and rural environments across multiple altitudes and seasons. On SegFly, we establish the Firefly baseline for RGB and thermal semantic segmentation and show that both conventional architectures and vision foundation models benefit substantially from SegFly supervision, highlighting the potential of geometry-driven 2D-3D-2D pipelines for scalable multi-modal aerial scene understanding. Data and Code available at https://github.com/markus-42/SegFly.

Medical image segmentation (MIS) is a fundamental component of computer-assisted diagnosis and clinical decision support. Over the past decade, numerous architectures specifically tailored to medical imaging have emerged to address domain-specific challenges such as low contrast, small anatomical structures, and limited annotated data. In parallel, rapid progress in computer vision has produced highly capable general-purpose vision models (GP-VMs) originally designed for natural images. Despite their strong performance on standard vision benchmarks, their effectiveness for MIS remains insufficiently understood. In this controlled empirical study, we examine whether specialized medical segmentation architectures (SMAs) provide systematic advantages over modern GP-VMs for 2D MIS. We compare eleven SMAs and GP-VMs using a unified training and evaluation protocol across three heterogeneous datasets, each covering different 2D imaging modalities, class structures, and data characteristics. Beyond segmentation performance, we employ linear mixed-effects models (LMMs) for statistical assessment and qualitative Grad-CAM visualizations to investigate explainability (XAI)-related model behavior. Our results imply that, for the analyzed settings, GP-VMs achieve performance comparable to that of specialized MIS models. Moreover, XAI analyses indicate that GP-VMs are capable of identifying clinically relevant structures despite the absence of explicit domain-specific architectural priors. These findings suggest that GP-VMs can represent a viable alternative to domain-specific methods for 2D MIS, highlighting the importance of informed model selection. All code and resources are available at GitHub.

Sign Language Production (SLP) faces a fundamental trade-off: direct text-to-pose models suffer from regression-to-the-mean effects, while dictionary-retrieval methods produce disjointed transitions. To resolve this, we propose a novel training paradigm that leverages sparse keyframes to capture the underlying kinematic distribution of human signing. By generating dense motion from discrete anchors, our approach mitigates regression-to-the-mean while ensuring fluid articulation. To achieve this at scale, we introduce FAST, an ultra-efficient sign segmentation model that automatically mines precise temporal boundaries. We then present SignSparK, a Conditional Flow Matching (CFM) framework that utilizes these temporal anchors to synthesize 3D signing sequences. This keyframe-driven formulation also unlocks Keyframe-to-Pose (KF2P) generation, making precise spatiotemporal editing of signing sequences possible. Furthermore, SignSparK scales across four distinct sign languages, constituting the largest multilingual SLP framework to date, and integrates 3D Gaussian Splatting for photorealistic rendering. Extensive evaluations demonstrate that SignSparK achieves state-of-the-art across diverse SLP tasks and multilingual benchmarks. Our code is available at https://github.com/JianHe0628/SignSparK.

Medical image analysis depends on accurate segmentation and controllable synthesis, but both tasks face severe spatial imbalance: lesions occupy small regions against large backgrounds. We study adaptive spatial weighting as a task-level design principle and instantiate it in two adapters. LAW learns per-pixel loss weights for mask-conditioned diffusion by modulating a ratio prior with a feature-dependent delta map, with normalization, clamping, and Dice regularization for stability. ORDER improves lightweight segmentation by adding selective bidirectional skip attention with stage-wise confidence gating. On held-out diffusion test sets, LAW lowers FID from 158.13$\pm$0.15 to 108.43$\pm$0.71 on Polyps, from 144.13$\pm$0.31 to 89.51$\pm$0.96 on KiTS19, and from 139.22$\pm$0.38 to 112.58$\pm$0.68 on BRISC, while improving held-out mask-recovery Dice from 0.681$\pm$0.013 to 0.825$\pm$0.003 on Polyps. When the resulting images are added to nnUNet training, downstream Polyps mDice rises from 71.7$\pm$0.4 to 74.1$\pm$0.8. On the cleaned Polyps segmentation protocol, the reported ORDER configuration reaches 76.3$\pm$1.9 mDice and 67.2$\pm$2.0 mIoU at 42K parameters and 0.11 GFLOPs, versus 70.3$\pm$1.5 mDice and 59.9$\pm$1.7 mIoU for matched MK-UNet. On BRISC under the same training recipe, ORDER reaches 77.4$\pm$0.8 mDice and 68.1$\pm$0.7 mIoU. These results position adaptive spatial weighting as a practical design idea for both medical diffusion and efficient segmentation.

Ambiguous 3D medical image segmentation often involves boundaries where different expert delineations are non-identical yet clinically plausible. Modeling such inter-observer variability requires a careful balance between diversity and anatomical fidelity: deterministic models preserve coherent volumetric structures but collapse expert disagreement into a single mask, while stochastic generative models can produce diverse samples but may introduce disconnected components or slice-to-slice inconsistency when generating full 3D masks from unstructured noise. We propose Volumetric Directional Diffusion (VDD), a prior-anchored diffusion framework that shifts stochastic generation from full-mask synthesis to residual boundary exploration. VDD uses a coarse consensus prediction as an anatomical anchor and learns a directional diffusion process to generate plausible boundary variations around ambiguous regions while preserving stable volumetric topology. Experiments on three multi-rater datasets, including LIDC-IDRI, KiTS21, and ISBI 2015, show that VDD improves uncertainty distribution alignment while maintaining competitive segmentation accuracy and 3D structural consistency. These results suggest that prior-anchored residual diffusion can model clinically plausible expert disagreement without sacrificing anatomical fidelity.

Medical image segmentation is a cornerstone of computer-assisted diagnosis and treatment planning. While recent multimodal vision-language models have shown promise in enhancing semantic understanding through textual descriptions, their resilience in "in-the-wild" clinical settings-characterized by scarce annotations and hardware-induced image degradations-remains under-explored. We introduce BiCLIP (Bidirectional and Consistent Language-Image Processing), a framework engineered to bolster robustness in medical segmentation. BiCLIP features a bidirectional multimodal fusion mechanism that enables visual features to iteratively refine textual representations, ensuring superior semantic alignment. To further stabilize learning, we implement an augmentation consistency objective that regularizes intermediate representations against perturbed input views. Evaluation on the QaTa-COV19 and MosMedData+ benchmarks demonstrates that BiCLIP consistently surpasses state-of-the-art image-only and multimodal baselines. Notably, BiCLIP maintains high performance when trained on as little as 1% of labeled data and exhibits significant resistance to clinical artifacts, including motion blur and low-dose CT noise.

Purpose: Developing generalizable medical image segmentation models is challenging because imaging data are distributed across institutions and differ in modality and acquisition protocol. Federated learning (FL) enables collaborative training without centralizing raw medical images, but cross-modality domain shifts between computed tomography (CT) and magnetic resonance imaging (MRI) can substantially reduce model performance. This study investigates augmentation-driven cross-modality FL for abdominal organ and whole-heart segmentation. Methods: We evaluate convolution-based spatial augmentation, frequency-domain argumentation, domain-specific normalization, and global intensity nonlinear (GIN) augmentation for multimodal segmentation. Abdominal organ segmentation and whole-heart segmentation are first evaluated using a 2D U-Net framework. For whole-heart segmentation, we additionally perform native 3D experiments using a self-configuring nnU-Net architecture on the CARE-WHS 2026 dataset, enabling evaluation of whether the observed cross-modality FL behavior persists when moving from slice-based 2D segmentation to volumetric 3D segmentation. Results: GIN provides the most consistent cross-modality performance among the evaluated approaches in the original 2D experiments. For pancreas segmentation, the Dice similarity coefficient (DSC) improved from 0.073 to 0.437 when CT data were incorporated through federated cross-modality training. In 3D whole-heart segmentation, FedGIN improved mean DSC over FedAvg from 0.8696 to 0.8901 on the unseen CT center and from 0.7160 to 0.7956 on the unseen MRI center. Relative to centralized GIN training, FedGIN retained 92.4% of performance on unseen CT data and achieved comparable performance on unseen MRI data (0.7956 versus 0.7937).

Deep learning has substantially advanced medical image segmentation, yet achieving robust generalization across diverse imaging modalities and anatomical structures remains a major challenge. A key contributor to this limitation lies in how existing architectures, ranging from CNNs to Transformers and their hybrids, primarily encode spatial information while overlooking frequency-domain representations that capture rich structural and textural cues. Although recent studies have begun exploring spectral information at the feature level, supervision-level integration of frequency cues-crucial for fine-grained object localization-remains largely untapped. To this end, we propose Phi-SegNet, a CNN-based architecture that incorporates phase-aware information at both architectural and optimization levels. The network integrates Bi-Feature Mask Former (BFMF) modules that blend neighboring encoder features to reduce semantic gaps, and Reverse Fourier Attention (RFA) blocks that refine decoder outputs using phase-regularized features. A dedicated phase-aware loss aligns these features with structural priors, forming a closed feedback loop that emphasizes boundary precision. Evaluated on five public datasets spanning X-ray, US, histopathology, MRI, and colonoscopy, Phi-SegNet consistently achieved state-of-the-art performance, with an average relative improvement of 1.54+/-1.26% in IoU and 0.98+/-0.71% in F1-score over the next best-performing model. In cross-dataset generalization scenarios involving unseen datasets from the known domain, it also exhibits robust and superior performance, highlighting its adaptability and modality-agnostic design. These findings demonstrate the potential of leveraging spectral priors in both feature representation and supervision, paving the way for generalized segmentation frameworks that excel in fine-grained object localization. Our code is available on GitHub.

Expert-annotated training data remains the critical bottleneck for AI in histopathology, particularly for rare pathologies where even dozens of cases may be unavailable. While data augmentation offers a solution, existing methods fail to generate sufficiently realistic lesion morphologies that preserve tissue-specific architectures. Here we present PathoGen, a diffusion-based generative model enabling controllable, high-fidelity lesion inpainting into benign histopathology images. We validate PathoGen across four datasets representing kidney, skin, breast, and prostate pathology. Quantitative assessment confirms PathoGen outperforms state-of-the-art baselines in image fidelity and distributional similarity. Evaluation by six expert pathologists revealed that synthetic images by PathoGen were only marginally distinguished from real tissue image slightly above chance (57.75% accuracy), demonstrating strong perceptual realism of PathoGen-generated lesions. PathoGen achieved the highest win rate (35.4%) when pathologists ranked generation quality against all baselines. Crucially, augmenting training sets with PathoGen-synthesized lesions improves segmentation Dice scores by up to 0.18 compared to traditional augmentations, with maximum benefit in data-scarce regimes. By simultaneously generating realistic morphology and pixel-level annotations, PathoGen effectively addresses both data scarcity and annotation cost, two critical bottlenecks in computational pathology development.

Background and Objective: Precise and scalable instance segmentation of cell nuclei is a fundamental prerequisite for computational pathology, yet gigapixel whole-slide images (WSIs) pose significant computational challenges. While patch-based processing is standard during training, existing methods are often limited to small tile sizes during inference due to architectural bottlenecks or reliance on computationally expensive post-processing for instance separation. We introduce a faster, scalable, and end-to-end framework capable of processing large-scale image tiles while accurately modeling biologically realistic overlapping nuclei. Methods: We propose LSP-DETR (Local Star Polygon DEtection TRansformer). The model represents nuclei as star-convex polygons and employs a lightweight transformer with linear complexity, enabling the processing of high-resolution images in a single forward pass. A novel radial distance loss accommodates annotation uncertainty, allowing the segmentation of overlapping nuclei to emerge naturally without explicit overlap labels. Results: LSP-DETR achieves state-of-the-art efficiency, with an inference time of 0.45 s/mm^2, a 3.2x speedup over StarDist, the next-fastest method. On PanNuke, the model achieves competitive accuracy (67.5 bPQ), while yielding an F$_1$-score of 0.964 in polygon overlap when evaluated against consensus annotations from two expert pathologists. Furthermore, it outperforms larger models such as LKCell in generalization robustness, reaching an F1-score of 85.0 on MoNuSeg. Conclusions: LSP-DETR bridges the gap between high-fidelity segmentation and practical clinical requirements by eliminating heuristic post-processing. By providing a scalable, linear-complexity solution that naturally handles overlaps between nuclei, this framework sets a new direction for efficient high-throughput WSI analysis in digital pathology.